Provider Demographics
NPI:1619046299
Name:CHAPPLE, JOHN GILBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GILBERT
Last Name:CHAPPLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E ARRELLAGA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2205
Mailing Address - Country:US
Mailing Address - Phone:805-966-2204
Mailing Address - Fax:805-966-7821
Practice Address - Street 1:511 E ARRELLAGA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-2205
Practice Address - Country:US
Practice Address - Phone:805-966-2204
Practice Address - Fax:805-966-7821
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA21284208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16411Medicare ID - Type UnspecifiedGROUP ID